MEDICARE: DR. HARRIET MARY SEGELCKE D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	14862	CA

General Provider Information

NPI Number	:	1134269442
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HARRIET MARY SEGELCKE D.C.

Provider Business Mailing Address
First Line	:	225 CABRILLO HWY S STE 110D
Second Line	:
City	:	HALF MOON BAY
State	:	CA
Zip	:	94019-1738
Country	:	US
Telephone Number	:	408-384-1186
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 CABRILLO HWY S STE 110D
Second Line	:
City	:	HALF MOON BAY
State	:	CA
Zip	:	94019-1738
Country	:	US
Telephone Number	:	408-384-1186
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/07/2007
Last Update Date	:	03/04/2020

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